Efficacy of an Extracorporeal Endotoxin Adsorber System during Hyperdynamic Porcine Endotoxemia
| Autor: | U. B. Brueckner, Michael K. Georgieff, K. Buttenschön, Balázs Hauser, Hendrik Bracht, Peter Radermacher, Zsolt Iványi, Pierre Asfar, Ulrich Ehrmann |
|---|---|
| Přispěvatelé: | Sektion Anästhesiologische Pathophysiologie und Verfahrensentwicklung, Universitätsklinikum Ulm - University Hospital of Ulm, Semmelweis Egyetem, Aneszteziológiai és Intenzív Terápiás Klinika, Hémodynamique, Interaction Fibrose et Invasivité tumorales Hépatiques (HIFIH), Université d'Angers (UA), Departement of Anaesthesiology [Ulm, Germany], Universitatsklinikum |
| Jazyk: | angličtina |
| Rok vydání: | 2009 |
| Předmět: |
Lipopolysaccharides
Male Time Factors Swine [SDV]Life Sciences [q-bio] Extracorporeal Pathogenesis Sepsis 03 medical and health sciences 0302 clinical medicine Animals Humans Medicine 030212 general & internal medicine business.industry Hemodynamics 030208 emergency & critical care medicine bacterial infections and mycoses medicine.disease Endotoxemia 3. Good health Endotoxins Hemoperfusion Oxygen Immunology Female Surgery Adsorption business Endotoxic shock |
| Zdroj: | European Surgical Research European Surgical Research, Karger, 2009, 43 (1), pp.53-60. ⟨10.1159/000218330⟩ |
| ISSN: | 0014-312X 1421-9921 |
| DOI: | 10.1159/000218330⟩ |
| Popis: | Background: Endotoxemia is a crucial factor in the pathogenesis of sepsis. Elimination of endotoxin is aimed at the reduction of sepsis-related morbidity and lethality. The objective of this study was to examine the impact of an endotoxin adsorber on hemodynamics, O2 exchange and metabolism during resuscitated porcine endotoxemia. Methods: Twenty pigs were randomized into 2 intervention groups (n = 7 each) and 1 control group (n = 6). Endotoxemia was induced by continuous intravenous application of lipopolysaccharide for 8 h. Adsorber therapy was started at the same time as the induction of endotoxemia or 2 h later. An extracorporeal hemoperfusion device using immobilized human serum albumin for endotoxin adsorption was used. Results: Hemodynamic, metabolic and acid-base parameters, as well as the kinetics of interleukin (IL)-6, IL-8, IL-10 and tumor necrosis factor-α, were characteristic for endotoxic shock. Endotoxin plasma levels were low (arterial, hepatic and portal vein). None of the parameters were significantly influenced by the adsorber system. Conclusion: Despite typical clinical signs of endotoxemia, the adsorber system had no significant effect on hemodynamic, metabolic and acid-base parameters during endotoxic shock. The reasons for the absence of an effect are elusive; however, failure of the method per se or exceeded capacity of the adsorber cannot be excluded. |
| Databáze: | OpenAIRE |
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